Abstract: The Guthrie Test has become the standard screening test for early detection of congenital metabolic disorders for newborn babies in New Zealand and is an accepted part of neonatal care. In neonatal care, decisions are made on behalf of babies usually by their parents and, for the Guthrie Test there is a requirement that health professionals obtain informed consent. This qualitative research utilised focus group methodology to discover what neonatal nurses in clinical practice consider when obtaining informed consent from parents for newborn screening, the Guthrie Test. The convenience sample consisted of seven registered nurses who volunteered to participate in the study. They all practice in the Neonatal Intensive Care Unit at Dunedin Public Hospital that provides Level 3 intensive care to neonates in the Otago/Southland regions. There are proven benefits of the current newborn screening programme and in the experience of this focus group not many parents choose to refuse. These neonatal nurses identified the rights of parents to have that choice and to make an informed decision. The findings from this research indicate the importance neonatal nurses place on patients' rights and the information provided to ensure that their rights are respected. However, the results indicated that there is a need for clarification of the purpose and process of informed consent for the Guthrie Test in the Neonatal Intensive Care Unit. Therefore providing sufficient, relevant information at an appropriate time and manner is considered necessary. The findings will be used to inform discussion related to the provision of best practice.

Abstract: An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process.

Abstract: This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work.

Abstract: This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. Four rest home residents were recruited, to talk about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi's analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants' satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured. Recommendations are made for improving the spiritual dimension of care, and for further research.

Abstract: A thesis submitted in partial fulfilment of the requirements for a Masters of Arts, Massey University, Palmerston North, New Zealand.

Abstract: Using thematic analysis, this study explored the phenomenon of effective education for critical care nursing practice by asking: What does effective education for critical care nursing practice mean to nurses currently practising in the specialty? Eighty eight critical care nurses from the South Island provided written descriptions of what effective education for critical care nursing practice meant to them. Descriptive statements were analysed to reveal constituents, themes and essences of meaning. Four core themes of personal quality, practice quality, the learning process and learning needs emerged. Appropriateness or relevance for individual learning needs is further identified as an essential theme within the meaning of effective education for critical care nursing practice. Shared experiences of the phenomenon are made explicit and discussed with reference to education and practice development in the specialty. The study results lend support to education that focuses on individual learning needs, and identifies work based learning as a potential strategy for learning and practice development in critical care nursing.

Abstract: In this paper, literature related to childhood obesity in New Zealand and internationally is explored to identify current issues, and the implications for nurses in community based child health practice are discussed. Themes that emerged from the literature relate to the measurement of obesity, links between childhood and adult obesity and issues for families. Studies that investigated maternal perceptions of childhood obesity found that mothers identified their child as being overweight or obese only when it imposed limitations on physical activity or when the children were teased rather than by referring to individual growth graphs. The implications for nursing in the area of child health practice are discussed. Understanding of the complex and emotive issues surrounding childhood obesity is required when devising health promotion strategies.